Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jul 2006
Randomized Controlled Trial Multicenter StudyA multicentre, randomised trial examining the effect of test procedures measuring emergence from post-traumatic amnesia.
Post-traumatic amnesia (PTA) tests that record different PTA durations in the same patient, thereby raising measurement accuracy issues, have been reported previously. A major problem lies in determining the end point of PTA. ⋯ Although no significant differences in the duration of PTA on the MOPTAS/WPTAS were recorded, emergence from the late stages of PTA occurred more promptly with the MOPTAS. The need for inclusion of both orientation and memory items in PTA tests is highlighted by the frequency of disorientation-amnesia dissociations. The patterns of results on the independent measures suggest that patients who are in PTA for > 4 weeks have probably emerged from PTA when they first score 12/12 on the MOPTAS/WPTAS, and this criterion can replace the traditional criterion.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2006
Endothelial cell activation markers and delayed cerebral ischaemia in patients with subarachnoid haemorrhage.
Endothelial cell activation may be connected with the pathogenesis of delayed cerebral ischaemia (DCI) after subarachnoid haemorrhage (SAH). ⋯ The rise in sP-selectin level during DCI is suggested to be the result of platelet activation, as levels of the other markers of endothelial cell activation were not increased after DCI unrelated to treatment. Whether a causal role of platelet activation is implicated in the development of DCI should be determined in further studies in which the relationship between concentrations of markers and treatment is taken into account.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2006
Insular cortical ischaemia does not independently predict acute hypertension or hyperglycaemia within 3 h of onset.
To test the hypothesis that insular cortical ischaemia is associated with acute hypertension and hyperglycaemia. ⋯ Raised blood pressure or serum glucose levels in hyperacute (<3 h) cerebral ischaemia is not independently predicted by insular involvement. Several hours are required for sympathetic manifestations of insular ischaemia to evolve.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2006
Thrombolysis in patients older than 80 years with acute ischaemic stroke: Canadian Alteplase for Stroke Effectiveness Study.
The benefit of intravenous tissue plasminogen activator (tPA) given within 3 h of acute ischaemic stroke to patients over 80 years of age is uncertain. ⋯ In carefully selected elderly patients, the use of intravenous tPA was not found to be associated with an increased risk of symptomatic intracerebral haemorrhage. Age-related differences were seen in the clinical characteristics and outcome in the elderly population.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2006
Case ReportsDura mater-associated Creutzfeldt-Jakob disease: experience from surveillance in the UK.
Between 1970 and 2003, seven cases of human dura mater-associated Creutzfeldt-Jakob disease (CJD) were identified in the UK. Furthermore, we identified a case of CJD in a porcine dura graft recipient. The mean incubation period of the human dura mater cases was 93 (range 45-177) months. The clinico-pathological features of the cases are described and compared with cases previously reported in the world literature.